Sima Bezawit Temesgen, Belachew Tefera, Abebe Fekadu
Public Health and Medical College, Jimma University, Jimma, Ethiopia.
Department of Community Medicine and Global Health, Institute for Health and Society, Faculty of Medicine, University of Oslo, Blindern, Oslo, Norway.
PLoS One. 2017 Jul 17;12(7):e0181032. doi: 10.1371/journal.pone.0181032. eCollection 2017.
Ethiopia is ninth among the world high tuberculosis (TB) burden countries, pastoralists being the most affected population. However, there is no published report whether the behavior related to TB are different between pastoralist and the sedentary communities. Therefore, the main aim of this study is to assess the pastoralist community knowledge, attitude and perceived stigma towards tuberculosis and their health care seeking behavior in comparison to the neighboring sedentary communities and this may help to plan TB control interventions specifically for the pastoralist communities.
A community-based cross-sectional survey was carried out from September 2014 to January 2015, among 337 individuals from pastoralist and 247 from the sedentary community of Kereyu district. Data were collected using structured questionnaires. Three focus group discussions were used to collect qualitative data, one with men and the other with women in the pastoralist and one with men in the sedentary groups. Data were analyzed using Statistical Software for Social Science, SPSS V 22 and STATA.
A Lower proportion of pastoralists mentioned bacilli (bacteria) as the cause of PTB compared to the sedentary group (63.9% vs. 81.0%, p<0.01), respectively. However, witchcraft was reported as the causes of TB by a higher proportion of pastoralists than the sedentary group (53.6% vs.23.5%, p<0.01), respectively. Similarly, a lower proportion of pastoralists indicated PTB is preventable compared to the sedentary group (95.8% vs. 99.6%, p<0.01), respectively. Moreover, majority of the pastoralists mentioned that most people would reject a TB patient in their community compared to the sedentary group (39.9% vs. 8.9%, p<0.001), respectively, and the pastoralists expressed that they would be ashamed/embarrassed if they had TB 68% vs.36.4%, p<0.001), respectively.
The finding indicates that there is a lower awareness about TB, a negative attitude towards TB patients and a higher perceived stigma among pastoralists compared to their neighbor sedentary population. Strategic health communications pertinent to the pastoralists way of life should be planned and implemented to improve the awareness gap about tuberculosis.
埃塞俄比亚是全球结核病负担较重的国家之一，排名第九，牧民是受影响最严重的人群。然而，尚无已发表的报告表明牧民社区和定居社区在与结核病相关的行为上是否存在差异。因此，本研究的主要目的是评估牧民社区对结核病的知识、态度和感知到的耻辱感，以及与邻近定居社区相比他们的医疗保健寻求行为，这可能有助于专门为牧民社区制定结核病控制干预措施。
2014年9月至2015年1月，在Kereyu区对337名牧民和247名定居社区居民进行了一项基于社区的横断面调查。使用结构化问卷收集数据。进行了三次焦点小组讨论以收集定性数据，一次是与牧民中的男性，一次是与牧民中的女性，还有一次是与定居群体中的男性。使用社会科学统计软件SPSS V 22和STATA对数据进行分析。
与定居群体相比，提及杆菌（细菌）是肺结核病因的牧民比例较低（分别为63.9%对81.0%，p<0.01）。然而，报告称巫术是结核病病因的牧民比例高于定居群体（分别为53.6%对23.5%，p<0.01）。同样，与定居群体相比，认为肺结核可预防的牧民比例较低（分别为95.8%对99.6%，p<0.01）。此外，与定居群体相比，大多数牧民提到社区中的大多数人会拒绝结核病患者（分别为39.9%对8.9%，p<0.001），并且牧民表示如果自己患有结核病会感到羞耻/尴尬（分别为68%对36.4%，p<0.001）。
研究结果表明，与邻近的定居人群相比，牧民对结核病的认识较低，对结核病患者持消极态度，且感知到的耻辱感较高。应规划并实施与牧民生活方式相关的战略健康宣传，以缩小结核病知识差距。
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